Healthcare professionals have a significantly higher risk of developing hand eczema, dermatitis, and other skin problems as compared to the general population. These conditions are not only problematic for healthcare works but also impact patient populations. For example, eczema contributes to the spread of infection in hospitals. More than 90% of people with moderate-to-severe eczema are colonized with Staphylococcus aureus. Staph infections can be deadly. In particular, antibiotic-resistant strains such as MRSA (methicillin-resistant Staphylococcus aureus) are difficult to control. The prevalence of eczema among healthcare employees is therefore a significant problem.
For people with eczema, washing hands with soap and water can lead to further irritation and prevent healing. That is why many healthcare workers instead rely on hand disinfectants as an alternative or a supplement to hand washing. It is estimated that 40% of all hospital-acquired infections comes from poor hand disinfection, and a primary reason for poor hand disinfection is irritated skin. Hand disinfectants or hand sanitizers are generally gel, foam, or liquid solutions with an active ingredient for killing microorganisms. Most hand disinfectants include alcohol in the form of ethanol or isopropanol.
Alcohol-based hand disinfectants can actually exacerbate the problem for those with eczema by promoting the autoimmune response that causes eczema. When exposed to alcohol, the Staphylococcus aureus and other bacteria that survive respond by producing a protective biofilm. Biofilms are known to impair cutaneous wound healing and reduce topical antibacterial efficiency, and they can also spread bacteria into the air. Meanwhile, antibiotic resistant bacteria such as MRSA proliferate within the biofilm, leading to many serious and deadly hospital infections. Eczema, especially among healthcare providers, remains a major public health concern.